Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 2015-00346 | NC |
N | 207X00000X | Orthopaedic Surgeon | 53802 | MN |
Y | 207X00000X | Orthopaedic Surgeon | OS016005 | PA |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 53802 | MN |
N | 207XX0801X | Orthopaedic Trauma Surgeon | 53802 | MN |
NPI | 1497952063 |
---|---|
Provider Name | Kyle James Hubler |
First Address | Williamsport, PA 17701-1900 |
Second Address | Williamsport, PA 17701-2647 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2007 |
Last Update Date | 18/06/2020 |